Two Adolescents with Gluten Sensitivity, Non Celiac, not Wheat Allergy, Associated with Non Specific Inflammatory Bowel Disease

Abstract

Submit Manuscript | http://medcraveonline.com and related prolamines present in wheat, barley and rye, that occur in genetically susceptible individuals, who have the human leukocyte antigen HLA-DQ2 and/or HLA-DW8 haplotypes. It is caracterized by inflammatory enteropathy, with variable degrees of severity, a wide range of gastrointestinal and/or systemic complaints, and the presence of celiac-specific auto-anti-bodies; is the more frequent inflammatory gastrointestinal disease in west countries [1][2][3][4].We describe two adolescents with digestive and systemic symptoms and signs related to gluten ingestion, with abnormal histopathologic findings and abscence of gluten and transaminase auto-antibodies, IgG and IgA, and negative for wheat IgE allergy, they had clinical remission on gluten free diet, and exaceration when they eat gluten, both associated to non-specific IBD, wich improved with prednisone. a. What is known i. CD can start at any age.ii. The signs and symptoms vary widely.iii. The difference between children and adults is that; children, could have failure to thrive and short stature.iv. Both can have both gastro-intestinal and extraintestinal manifestations.v. Extra-intestinal manifestations of CD can improved o disappeared with gluten free diet, as in the boy, in which chronic constipation, since pre-school age to up tu date, finished in few days, when he started free gluten diet.b. What is less known i. Chronic constipation could be the only symptom of CD.ii. IBD can be associated to CD. c. What is newi. IBD can be associated, not only to CD, but to NCGS, and, perhaps, WA. Case Report Case 1A 12 years old boy begin with anorexia and weight loss (49 to 40.8 Kg) since january to april12-17. He has normal activity.Since baby, his bowel movements were 1-2 per week, Bristol 1 to 3, feces frequently stuck in toilet.Exploration: Weight 40.8 Kg, height 1.58 meters. BMI 16.3 (C 25). Thin, active, flat abdomen, without active neither passive pain, nor abnormal bowel sounds.Laboratory: Negative anti-gliadin IgG and IgA, antitransglutaminase IgA, anti-total and wheat IgE.High Endoscopy: Diffuse capillary congestion in stomach. Duodenum is, macroscopically, normal.Coloncoscopy: Normal ileum. Deformed cecal valve by edema. Ceccum with visible taenias. Capillaries are lost in surrounding appendiceal mucosa. Mucosa, since ceccum to two proximal thirds of transverse colon, with paralel folds, formed by diffuse edema, and diffuse punctate hemorrhage.Distal transversal and descending colon with normal mucosa. Capillaris are lost in sigmoid by edema, diffuse hemorrhage and whitsh, round, and tiny superficial injuries. AimDescribe clinic, endoscopic and histopathology findings, and response to treatment in a 12 years old boy and a 17 year old girl, With NCGS, associated to IBD.